MEDICARE: DR. SARAH LYNN WERTSBAUGH O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPT.0003091	CO
2	152W00000X	Optometrist	6340	OH
3	152W00000X	Optometrist	OPT.006340	OH

General Provider Information

NPI Number	:	1811397896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH LYNN WERTSBAUGH O.D.

Provider Business Mailing Address
First Line	:	8614 WESTWOOD CENTER DR FL 9
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22182-2442
Country	:	US
Telephone Number	:	703-847-8899
Fax Number	:	571-223-6780

Provider Business Practice Location Address
First Line	:	2525 FAR HILLS AVE
Second Line	:
City	:	OAKWOOD
State	:	OH
Zip	:	45419-1505
Country	:	US
Telephone Number	:	937-298-0550
Fax Number	:	937-298-5404

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2014
Last Update Date	:	11/01/2023

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